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CONTINUING PROFESSIONAL DEVELOPMENT
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1. In relation to use of medicines in
children, which of the following is
a) Medicines used in many children are not
specifically indicated for children and as
such are considered ‘off-label use’.
b) Children are not miniaturised versions
of adults, so a simple ‘scaling down’ of
adult doses is not always appropriate.
c) Differences in pharmacokinetics means
the way young children experience the
pharmacological effects of medicines
can differ from older children, and
d) All of the above.
2. A child’s age can affect the
pharmacokinetics of medicines in
ways different from adults. Which of
the following is TRUE?
a) Absorption: Children have increased
gastric acid secretion which can
increase the absorption of acid-labile
medicines and reduce absorption of
b) Distribution: Plasma protein levels and
protein binding ability are increased
in children, leading to increases in
unbound concentrations of medicines,
so higher doses of highly protein bound
medicines are required.
c) Metabolism: The CYP450 isoenzymes
are not all present at birth, and adult
levels of individual CYP450 isoenzymes
are reached at various times, leading to
metabolism of medicines being greatly
variable even between neonates, infants
d) Elimination: Children have immature
renal function, but higher renal blood
flow and higher glomerular filtration
rates compared to adults, which
generally results in an increase in renal
excretion of medicines.
3. Which of the following principles
in relation to calculating doses in
children is TRUE?
a) In underweight children, it is
recommended that ideal body weight
be used for calculating doses.
b) The general recommendation is that the
maximum dose for a child should not
exceed the usual adult dose.
c) Body surface area is easy to calculate
accurately, and is generally considered
to be more accurate than weight.
d) The age of the child does not provide
any helpful information when
calculating paediatric doses.
4. When calculating doses for
oedematous or obese children,
which ONE of the following is TRUE?
a) Generally, doses should be calculated
using total body weight.
b) Using total body weight to calculate
doses can result in sub-therapeutic
c) Generally, doses should be calculated
using ideal body weight.
d) Using ideal body weight to calculate
doses can result in over doses.
5. Children are considered an adult for
dose calculation purposes when they
a) Between 1–12 years of age.
b) Between 5–12 years of age.
c) Over 1 month to 1 year old.
d) Over 12 years of age, or weighing
40–50 kg, unless a dose for adolescents
1. Sansom LN, ed. Australian pharmaceutical formulary and
handbook. 22nd edn. Canberra: Pharmaceutical Society
of Australia; 2012.
2. Scottish Neonatal and Paediatric Pharmacists Group
(SNAPP), NHS Education for Scotland (NES). An
introduction to paediatric pharmaceutical care. 2010. At:
3. Merck Manuals. Pharmacokinetics in children: Principles
of drug treatment in children: Merck manual professional.
2013. At: www.merckmanuals.com/professional/
4. AMH Editorial Advisory Subcommittee – Paediatric, eds.
AMH Children’s dosing companion. Adelaide: Australian
Medicines Handbook; 2014.
5. Rossi S, ed. Australian medicines handbook. Adelaide:
Australian Medicines Handbook; 2014.
6. Johnson TN. The development of drug metabolising
enz ymes and their influence on the suseptibility
to adverse drug reactions in children. Toxicology
7. Sydney Children’s Hospital. Drug dosing for overweight
and obese patients – SCH Practice Guideline. 2013. At:
8. Kemp CA, McDowell JM, eds. Paediatric Pharmacopoeia.
13th edn. Melbourne: Royal Children’s Hospital; 2002.
9. Centers for Disease Control and Prevention. Healthy
weight: Assessing your weight: BMI: About BMI for children
and teens. 2014. At: www.cdc.gov/healthyweight/
10. Centers for Disease Control and Prevention. Healthy
weight: Assessing your weight: BMI: About BMI for adults.
2014. At: www.cdc.gov/healthyweight/assessing/bmi/
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